INFLUENCE OF PRIMARY STENTING IN ACUTE MYOCARDIAL INFARCTION ON LEFT VENTRICULAR FUNCTION

Abstract

Introduction: Myocardial infarction is fatal one-third of patients. In others, concequences can be different forms and degrees of complications, e.g. left ventricular dysfunction. Fibrinolythic therapy is the only non-invasive treatment that directly influences the infarction outcome. The purpose of the study was to compare systolic function of the left ventricle measured by ejection fraction in circumstances in which an acute myocardial infarction was treated by primary stent implantation, by administration of fibrinolytic agent streptokinase, and medical treatment when none of the above mentioned methods has been used. Material and methods: A retrospective-prospective study was conducted with a sample of 90 patients, that were hospitalized in 2005 and 2006 for acute myocardial infarction, mean age being of 56±7. Patients were divided into three groups, with 30 patients in each: a group of patients refered to primary stenting, a group that received streptokinase, and a group of patients that were not treated with either of these methods. Elecrocardiogram and echocardiographic study were performed on all patients. Results: Ejection fraction was 58%±8 in stented group, 47%±7 in streptokinase group, and 33%±8 in group without either (p< .001). Discussion and Conclusion: Global systolic left ventricular function was significantly better in the group of stented patients compared to the one in patients treated with streptokinase. Streptokinase administered in the first 6 hours from myocardial infarction onset significantly improves preservation of left ventricular systolic function compared to conditions in which no fibrinolysis is used.